Saratov JOURNAL of Medical and Scientific Research

Dovgalevsky Ya.P.

Saratov Scientific Research Institute of Cardiology, Chief Research Assistant, Candidate of Medical Science

Prognostic value of level of brain natriuretic peptide in patients with acute coronary syndrome without symptoms of heart failure

Year: 2017, volume 13 Issue: №1 Pages: 041-046
Heading: Internal Diseases Article type: Original article
Authors: Furman N.V., Puchinyan N.F., Dolotovskaya P.V., Dovgalevsky la.P., Panina A.V.
Organization: Saratov Institute of Cardiology, Russia
Summary:

Purpose of the study: to evaluate the prognostic value of brain natriuretic peptide (BNP) as a predictor of cardiovascular events in patients with acute coronary syndrome (ACS) within one year after hospitalization. Material and Methods. The study included 201 patients, including 150 men and 51 women, who were treated in the emergency department of cardiology with ACS including 96 patients without symptoms of CHF and/or AHF. Results. All patients were divided into groups depending on the presence signs of heart failure of CHF and/or AHF at the time of admission: patients with no signs of heart failure were divided into 2 groups: those with BNP levels >101 pg/mL (group 1; n=37) and <100 pg/mL (group 2; n=59); the third group consisted of patients with symptomatic HF (n=105). In patients without clinical signs of CHF and/or AHF with elevated level of the BNP at the time of hospitalization was observed significantly increased risk of unstable angina during the year compared to patients with normal levels (OR 2.83 [95% Cl: 1.1—7.24], p=0.04). In patients without clinical signs of CHF and/or AHF with elevated BNP levels at the time of hospitalization compared to patients with AHF and/or CHF, had no statistically significant differences in the long-term prognosis. Conclusion. Patients with ACS in the absence of CHF and/or AHF but with elevated levels of BNP at admission should be attributed to the group of high risk for cardiovascular complications. Increasing the level of BNP in ACS patients at admission has an adverse value for long-term outcome and can be used as an additional risk marker.

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Leukocytosis and clinical outcomes in patients with myocardial infarction with ST-segment elevation

Year: 2013, volume 9 Issue: №4 Pages: 673-678
Heading: Сardiology Article type: Original article
Authors: Panina A.V., Dolotovskaya P.V., Puchinyan N.F., Dovgalevsky Ya.P., Furman N.V.
Organization: Saratov Institute of Cardiology, Russia
Summary:

The aim of the study is to evaluate the frequency of occurrence of leukocytosis and its prognostic value for the course and outcome of myocardial infarction with ST-segment elevation. Material and Methods. The study included 245 patients aged 61,2 years, who were on treatment at the Department of Emergency Cardiology with diagnosis of acute myocardial infarction with ST-segment elevation. Results. Leukocytosis (white blood cell levels of more than 10*109/L) was observed in 34,7% of patients. The presence of leukocytosis was associated with increased incidence of congestive heart failure class IV at Killip, ventricular fibrillation and lethal outcomes during hospitalization. There were no significant differences in the incidence of adverse events in the long-term period between the patients with leukocytosis and with normal level of white blood cells. Conclusion. Increased levels of white blood cells (more than 10*109/L) in patients with myocardial infarction with ST-segment elevation is associated with a significantly increase relative risk of cardiogenic shock (Odds ratio 5,2, 95% Cl, 1,7-15,8, p=0.001), ventricular fibrillation (Odds ratio 8,5, 95% Cl, 1,9-38,3, p=0.001) and death during hospitalization (Odds ratio 2,47, 95% Cl, 1,87-38,4, p=0,03). The level of white blood cells on admission to hospital may be used as one of the additional factors predicting the risk of patients with myocardial infarction with ST-segment elevation during hospitalization.

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Interdependence of parameters of varia-tional pulsometry, entropy of heart rate, temporal and spectral analyses of heart rate variability in normal state and in ischemic heart disease

Year: 2011, volume 7 Issue: №3 Pages: 607-611
Heading: Internal Diseases Article type: Original article
Authors: Durnova N.Yu., Dovgalevskiy Ya.P., Burlaka A.N., Kiselev A. R., Furman N.V.
Organization: Saratov Institute of Cardiology, Russia
Summary:

The research goal is to study the correlation between indices of variational pulsometry, entropy of heart rate, temporal and spectral analyses and heart rate variability in healthy patients and patients with coronary heart disease. Materials. Of the study are indicators of variational pulsometry and temporal and spectral analyses from 111 patients with coronary heart disease and in 61 healthy individuals. Results. Most parameters of HRV correlated with each other. In healthy patients the greatest independence was characterized by Mo and LF/HF, in patients with coronary artery disease — only by LF/HF Significant correlation with SDNN RMSSD, TP, LF, HF was determined. Conclusion. The variational pulsometry, temporal and spectral analyses of HRV and entropy of heart rate provide HRV assessment. The indices are interdependent and indicate interchangeability of methods

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Multifactor discriminant analysis of electrocardiograms at screening patients with ischemic heart disease

Year: 2010, volume 6 Issue: №1 Pages: 076-081
Heading: Internal Diseases Article type: Original article
Authors: O.K. Rybak, Ya.P. Dovgalevsky, N.Yu. Durnova, A.N. Burlaka
Organization: Saratov Institute of Cardiology, Russia
Summary:

The aim of the study is to create a mathematical model of non-invasive diagnostics of coronary heart disease. Research materials include indicators of heart rate variability, time and speed characteristics of repolarization phase of electrocardiograms obtained in 111 patients with coronary heart disease and in 92 healthy individuals. As a result of the multifactor discriminant analysis decisive diagnostic rule has been worked out. The proposed method allows to detect coronary artery disease in 97.7% of cases

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